Within eight and a half years, half the men had died of a second heart attack, and we opened the sealed envelope. Could we predict who would have a second heart attack? None of the usual risk factors predicted death: not bloodpressure, not cholesterol, not even how extensive the damage from the first heart attack. Only optimism, eight and a half years earlier, predicted a second heart attack [i] : of the sixteen most pessimistic men, fifteen died. Of the sixteen most optimistic men, only five died.
This finding has been repeatedly confirmed in larger studies of cardiovascular disease, using varied measures ofoptimism:
Veterans Affairs Normative Aging Study. In 1986, 1,306 veterans took the Minnesota Multiphasic Personality Inventory (MMPI) and were tracked for ten years. During that time, 162 cases of cardiovascular disease occurred. The MMPI has an optimism-pessimism scale that reliably predicts mortality in other studies. Smoking, alcohol use, blood pressure, cholesterol, body mass, family historyof CVD, and education were measured, as was anxiety, depression, and hostility, and all of these were controlled for statistically. Men with the most optimistic style (one standard deviation above average) had 25 percent less CVD than average, [ii] and men with the least optimism (one standard deviation below the mean) had 25 percent more CVD than average. This trend was strong and continuous,indicating that greater optimism protected the men, whereas less optimism weakened them.
European Prospective Investigation. More than 20,000 healthy British adults were followed from 1996-2002 during which 994 of them died, 365 of them from CVD. Many physical and psychological variables were measured at the outset of the study: smoking, social class, hostility, and neuroticism, for example.Sense of mastery was also measured by seven questions:
I have little control over the things that happen to me.
There is really no way I can solve some of the problems I have.
There is little I can do to change many of the important things in my life.
I often feel helpless in dealing with the problems of life.
Sometimes I feel that I am being pushed around in life.
What happens to me in thefuture mostly depends on me.
I can do just about anything I really set my mind to do.
These questions capture the continuum from helplessness to mastery. Death from cardiovascular disease was strongly influenced by a sense of mastery, [iii] holding smoking, social class, and the other psychological variables constant. People high (one standard deviation above the mean) in mastery had 20percent fewer CVD deaths than those with an average sense of mastery, and people high in a sense of helplessness (one standard deviation below the mean in a sense of mastery) had 20 percent more CVD deaths than average. This was also true of deaths due to all causes and—to a lesser extent but still significant statistically—of deaths from cancer.
Dutch Men and Women. Beginning in 1991, 999...